Wiener medizinische Wochenschrift最新文献

Since its beginnings in the 1970s, telemedicine has advanced extensively. Telemedicine is now more accessible and powerful than ever thanks to developments in medical imaging, Internet accessibility, advancements in telecommunications infrastructure, exponential growth in computing power, and related computer-aided diagnoses. This is especially true in the field of ophthalmology. With the COVID 19 pandemic serving as a catalyst for the widespread adoption and acceptance of teleophthalmology, new models of healthcare provision integrating telemedicine are needed to meet the challenges of the modern world. The demand for ophthalmic services is growing globally due to population growth, aging, and a shortage of ophthalmologists. In this review, we discuss the development and use of telemedicine in the field of ophthalmology and shed light on the benefits and drawbacks of teleophthalmology.

Replacement of damaged corneal tissue with a clear transplant represents a viable solution for restoring vision in patients with corneal blindness. Among organ transplants, corneal transplantation occupies a unique status due to the cornea's lack of vascularization. This avascular nature makes immune compatibility testing between donor and recipient unnecessary and reduces the risk of transplant rejection, making corneal transplantation the most successful organ transplant procedure worldwide. Over the past century, corneal transplantation has undergone a transformative journey, evolving from full-thickness keratoplasty to highly refined techniques that selectively target individual diseased corneal layers. These modern lamellar approaches aim for faster recovery times and reduced rejection rates. The global demand for corneal graft tissue far exceeds the availability of donor tissue, leading to prolonged waiting times for patients in need of transplantation. Modern therapeutic strategies are expected to support or potentially even replace transplantation of corneal layers in the future.

Background and objective: Hospital-acquired infections (HAI) cause a significant risk to patient maintenance and wellbeing, particularly within the specialized environment of a trauma center. This study focuses on investigating the frequency of HAI in a trauma center through a comprehensive surveillance and monitoring system.

Methods: This observational study, conducted between January 2023 and June 2023, focused on the 16-bed trauma center. HAI diagnoses were based on the centers for disease control and prevention (CDC) definitions that typically include specific criteria for different types of infections, for example, urinary tract infections, surgical site infections, bloodstream infections, and others.

Results: Among the 160 trauma center-admitted patients, 89 were included in the study. 44 patients contracted HAI, resulting in a frequency of 49.4%. The incidence rates (IR) were 21/1000 central venous catheter (CVC) days for catheter-related bloodstream infections (CRBSI), 10/100 urinary catheter days for catheter-associated urinary tract infections (CAUTI), and 34/1000 ventilator days for ventilator-associated pneumonia (VAP).

Conclusion: The HAI percentages noticed in the trauma center are comparatively lower than those reported in other developing country hospitals. The incidence of VAP aligns with findings from other studies.

The emergence of Vienna as a leading center of medical criminalistics has increased research on the physiological differences between criminals and normal people. In the second half of the nineteenth century, criminologists sought to explain human immorality and criminal behavior. In this regard, the work of Moriz Benedikt was of particular significance. This paper argues that the gruesome cases of serial killers who targeted maidservants were instrumental in the rise of forensic medicine and criminalistics in Vienna.

RN Braun observed that frequencies of health disorders in general practice are so consistent that he called his discovery "Case Distribution Law". Our study compares morbidity data from methodologically similar surveys in primary care practices over a period of fifty years. Frequency ranks were determined for each observation period and the first 150 ranks were compared with Spearman's correlation coefficients. All correlations were consistently positive. Frequency ranks were strikingly similar for surveys carried out at approximately the same time, especially when nomenclatural matching had been carried out before data collection. Ranks were also very similar where clear disease classifications were possible, but less so for non-specific symptoms.The consistency of the distribution of health disorders helps develop diagnostic strategies (diagnostic protocols) and appropriate labeling for non-specific, diagnostically open symptom classifications. According to Braun's considerations, the regularity of case distribution plays an important role in the professionalization of primary care.

Clinicians face significant diagnostic challenges when dealing with nodal lesions of the lung. The majority of lung nodules are benign; however, a significant number can be cancerous. Dirofilaria infestation should also be considered in the differential diagnosis of nodal lung lesions. Most patients with Dirofilaria infestation are asymptomatic. To determine the etiology of nodal lung infiltrations, procedures like radiological imaging, bronchoscopy, endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA), transthoracic biopsy (TTB), tumor markers, nonspecific serological tests, or surgical removal of the lung coin lesions can be performed. Coil marking of the smaller lung lesions under computed tomography (CT) guidance is a helpful tool in determining the position and localization of the nodal lung lesions. Video-assisted thoracoscopic surgery (VATS) or robot-assisted thoracoscopic surgery (RATS) wedge resection is a diagnostic and therapeutic method of choice. No additional treatment of Dirofilaria other than wedge resection of the lung is necessary.

Background: Biosimilar drugs offer a valuable opportunity for healthcare systems worldwide, providing significant cost savings and ensuring the same level of effectiveness and safety in the treatment of chronic conditions. These savings can be reinvested into continuous medical innovations.

Methods: A search was carried out to assess the use of key biosimilar medications across various therapeutic areas within an Italian health authority that serves a population of over 1 million people. Data on usage, costs, and the number of patients treated were obtained from the company databases. In addition, a comparison with the year 2022 was performed, aiming to identify any increase in the use of biosimilar drugs during 2023.

Results: The analysis of 2023 revealed that a large majority of the studied active ingredients are administered as biosimilar medications, with only a few exceptions. Resistance remains in the prescription of adalimumab and etanercept, with spending on the originators of close to 3 million euros.

Conclusion: The comparison between 2023 and 2022 highlighted the growing adoption of biosimilar medications. This positive trend suggests the potential for achieving full utilization in the near future. Such a result would significantly benefit the national healthcare system and the public, ensuring a healthcare approach that is both effective and sustainable.

Bilateral tubal pregnancy (BTP), a rare form of ectopic pregnancy, occurs in 1/200,000 pregnancies and typically follows assisted reproductive techniques (ARTs). We report a case of spontaneous BTP in a 34-year-old woman presenting with acute abdomen and no prior history of ART. The diagnosis was established 27 days after initial presentation via transvaginal ultrasonography and elevated beta human chorionic gonadotropin (beta-HCG). Following diagnostic laparoscopy, bilateral salpingectomy was performed. This case highlights the possibility of BTP, emphasizing the need to carefully inspect the contralateral adnexa when treating a "unilateral" ectopic pregnancy.

This study is the first to describe research conducted by the GDR State Security on polygraphs and voice analyzers and their conspiratorial use. Stasi files are used to show that the so-called lie detector was also used in the GDR. Up until the late 1960s, MfS superiors considered psychophysiological tests with the polygraph to be questionable and "ethically and morally reprehensible". This did not prevent a few experts from conducting extensive research. In addition, own spies were trained to pass polygraph tests in the West without being recognized. With the development of voice analyzers in the early 1970s, the MfS expanded its psychophysiological research. Voice analyses were carried out in hundreds of cases - to identify informers and in criminal investigations. All of the equipment came from the West and was procured despite embargo regulations. Shortly before the end of the GDR, use and research were to be expanded. The public knew nothing about this. There were only indications in the analyzed files that the psychophysiological devices were being used for civilian purposes. The Stasi files on this subject have not yet been fully indexed.